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Dating of multidose vials

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There has been much more attention recently on multidose vials, particularly the expiration date of these vials, especially from regulatory organizations such as CMS and The Joint Commission. The following is an email interview with Susan A. Q: Why have multi-dose vials been an issue in the past, and why do they continue to be problematic for some facilities? A: Multi-dose vials have been and continue to be a confusion for healthcare personnel HCP because they either are not fully aware of or do not follow basic infection control practices as they pertain to vials.
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Joint Commission Outlines Requirements for Usage of Multi-Dose Vials

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Blog # Multi-dose Vial Expiration Date vs BUD-Beyond Use Date – ATHNA

A multi-dose vial is a vial of liquid medication intended for parenteral administration injection or infusion that contains more than one dose of medication. Multi-dose vials are labeled as such by the manufacturer and typically contain an antimicrobial preservative to help prevent the growth of bacteria. The preservative has no effect on viruses and does not protect against contamination when healthcare personnel fail to follow safe injection practices. Multi-dose vials should be dedicated to a single patient whenever possible.
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Questions about Multi-dose vials

Today most vaccines used in travel health come in single use vials or pre-filled syringes. A few vaccines can still be ordered in multi-dose vials such as injectable typhoid and inactivated IPOL polio. A multi-dose vial MDV contains more than one dose of vaccine. Because MDVs typically contain a preservative to help prevent the growth of microorganisms, they can be entered or punctured more than once. After the maximum number of doses has been withdrawn, the vial should be discarded, even if there is residual and the expiration date has not been reached.
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On one hand, multidose vials are a great way to get more for your money with expensive medications. On the other hand, they can cause multiple complications if staff members are not following very precise procedures. In fact, the best solution for multidose vial complications is not to use them. This brings up the second problem: expiration dates. Multidose vials have a limit on how long they can be stored after being opened or punctured; typically that limit is around 28 days.
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